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When I interact with other gay men on these social networks. It's like I'm looking through the looking glass. I know dating is possible, I know a partner is out there for me somewhere. But we constantly strive for perfection. We look for it in our bodies and lives and everything and we see imperfections as something we run away from. Straight, gay, whatever.

Because no one feels like they're on equal footing, that no one feels like they're on sturdy ground. The bonds that make our communities and culture strong aren't forming.

How old are you. This is something that drops as the years go by. A lot of guys over 40 aren't exclusively superficial about the criteria for sex and dating and love. It seemed to me a lot of us in our 20's were into the surface, but so many reach a moment where suddenly looks and material competition etc etc just fade way down the hierarchy.... And on that matter, I've met guys of every age who just aren't wired to motivated mostly by looks and status... Sure a lot are. But a lot are not.

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ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

The situation seems a bit ominous... If the walls of the anus aren't all that protective, and some of us are going to join into a bareback culture, I dunno..... Ding dong.... I'll opt out for the moment, but no promises.

Yes it sure does. And I'm proof it's not just the bottoms that have something to worry about. Apparently my uncut cock is pretty sensitive. But then again I have roughed it up even jacking off, no bareback sex required...

I never opted in to any of this culture before testing poz either. I still have not tried the drugs, fisting, or even cigarette smoking. Maybe I am just a late bloomer. At least I go to the bathhouses now. Guys tend to be slightly less judgmental there, but only slightly.

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In any event. Isn't it more pleasurable to be able to drink wine for the rest of your life then to have some fleeting hot sensations of unprotected sex.

Now, why does it have to be one or the other ?I like having sex in my hot tub with a glass of wine on the side.I hope the amount of chlorine in the water is enough of an HIV viricide.Chlorinated water doesn't make for very good lube, though.

Now, why does it have to be one or the other ?I like having sex in my hot tub with a glass of wine on the side.I hope the amount of chlorine in the water is enough of an HIV viricide.Chlorinated water doesn't make for very good lube, though.

I mentioned the drinking because obviously when diagnosed Hep C I could not drink. And the future looked grim on the drinking. If I had not cleared the virus, he wasn't willing to offer treatment thoughout 2013, as he said it was ethical to wait until the next treatment which will be stellar. Also, there's always the chance the Hep C treatment wouldn't work. Or that it would take a long time. And Hep C can come with a lot of damage. So I meant, I was pretty depressed thinking some bareback sex (a pleasure) could wreck, for life, another pleasure - drinking! And wine, champagne, cocktails, a swig of whisky - its a much bigger pleasure in life, (then some unprotected sex), and so involved in social life, as well.

I piped up in this thread because I feel like I got lucky on this Hep C experience. When I got HIV, my immune response was shit, needed HAART within a few months. And HIV is forever (for the hazy distant future, at least)... It was reassuring that my body managed a great response to Hep C. But mostly, I am just glad I don't have to carry this now forward, making life more complicated.

As I said, its another change of my mindset about sex, risk, priorities, etc., as the years go on.

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ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

I never opted in to any of this culture before testing poz either. I still have not tried the drugs, fisting, or even cigarette smoking. Maybe I am just a late bloomer. At least I go to the bathhouses now. Guys tend to be slightly less judgmental there, but only slightly.[Ö]I like having sex in my hot tub with a glass of wine on the side.

It's funny how people judge each other, by the way.

I know many of you wouldn't speak to me in real life because I used to be an IV drug user. Meanwhile, you seem like raging alcoholics and sex addicts to me, someone who doesn't drink and mostly did the party drugs *alone*. Party of one. Sex is a way to earn a place to sleep, not something to be enjoyed, silly people.

I know many of you wouldn't speak to me in real life because I used to be an IV drug user.

I was an IV drug user also and have never experienced prejudice from these people because of that. I've talked to some people on the phone or via skype also, and never felt judgment. I guess I don't know why you would say that.

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I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

I was an IV drug user also and have never experienced prejudice from these people because of that. I've talked to some people on the phone or via skype also, and never felt judgment. I guess I don't know why you would say that.

Oh, that's totally fair. I actually am thinking badly *and* I mis-expressed what I meant, so that's just wrong in every direction!

Most people in the world seem pre-disposed to not liking IV drug users, even former ones. This is not something I've ever had to deal with because

1) I'll take friends from any walk of life because I've been up and down the socio-economic spectrum on two continents. Some of my best friends were ex-con IV drug users in Siberia, long before I would ever have considered using myself. IV drug use - on its face - never seemed worse than alcoholism in my book. IV drug users who beat people up (which I've seen) are doing bad things, but so are alcoholics who beat people up (which I've seen). I've known IV drug users who hold their shit together, and I've known cocaine users who steal (from me, my last $300 once). I've known completely sober people who steal too. I guess my point is, I try (try) to let concrete actions like "steal, beat, murder, rape" take precedence in my consideration of people over labels like "hooker, junkie, positive, evangelical". No one's perfect, but I do try. We all judge, though. It's impossible not to, and would probably be a bad thing (naivete kills). How we choose to treat people we've judged is more important, IMHO, than whether or not we judge.

2) I did it for the first time in summer 2011, and it was a long time before the next time (spring 2012, when I spent a weekend with a guy jumping from hotel to hotel shooting up and falling in love, lol). A couple of months later I spent another weekend like that (without the love, but I learned a lot about opera and Jesus, which may surprise you to hear). Then in September or so it became weekly, then the week of Sandy (last week of Halloween, which fucked me 40 ways from Tuesday) it became daily until my diagnosis on 11/20, then weekly again until Christmas, then I stopped. (People have trouble believing I just "stopped", but I don't find crystal all that physically addictive. Am I fooling myself? I don't know. I don't have any physical desire to do it again, but hanging out with people is nice, and that only happens when high. I don't plan to do it again, but I never planned to do it in the first place!)

3) I didn't "admit" I had become an IV drug user to anyone until after I had "quit", and mostly only online here or to aid workers and that doctor who treated me completely differently once I told him. I've come out about a lot of things: atheist in Appalachia, gay in Siberia, positive in NYC. But I guess this is the first time I've had to come out about something that I actually am ashamed of, and people's reactions are, clearly, not the same as they are to things like gay, atheist or positive. I'm fairly pessimistic anyway, though assuming the worst is not far from the truth with revealing IV drug use. It's just a bridge too far for a lot of people.

So, it's new, and most of my revelations of it have been met with neither sympathy or understanding but contempt. Understandably. I am what's wrong with the world.

So, when I said most of "you", I meant "the world", but there are two problems there:

1) I shouldn't assume the world hates me for having shot up. Maybe they would/do, but the assumption isn't helpful, and speech creates veracity.2) "You" are not "the world".

I'll be honest, I still feel like most people who read these forums would not be cool with me because of this one fact, but, yes, that's not true of most of the people who post here, I guess.

My main point in posting that was about how silly it is that I "judge" drinkers and people who have sex without having to, especially since I don't want those people judging me.

I know many of you wouldn't speak to me in real life because I used to be an IV drug user. Meanwhile, you seem like raging alcoholics and sex addicts to me, someone who doesn't drink and mostly did the party drugs *alone*. Party of one. Sex is a way to earn a place to sleep, not something to be enjoyed, silly people.

I'll try not to judge you if you promise the same, haha.

Girl, the forums would go silent if people stopped speaking to people who "used to be an IV drug user."

I was an IV drug user but I have never really dwelled on what people think of me for admitting it . I have been told by more than a few people that they admire the fact I was able to stop and make some sense out of my life .

There are people who will never understand what living the life of an addict is and I can be happy for them that they never had to find out . I can also continue to live a full happy life without their understanding .

You've totally hit the nail on the head !!! I also have ton of self worth issues and have had to constantly fight. I'm also just burned out from fighting all my fights. I'm tired of feeling so alone all the time.

When I interact with other gay men on these social networks. It's like I'm looking through the looking glass. I know dating is possible, I know a partner is out there for me somewhere. But we constantly strive for perfection. We look for it in our bodies and lives and everything and we see imperfections as something we run away from. Straight, gay, whatever.

Because no one feels like they're on equal footing, that no one feels like they're on sturdy ground. The bonds that make our communities and culture strong aren't forming.

Hey Core,

I found that when I stopped looking for what I thought I "wanted" and instead looked for what I "needed" that there are plenty of guys out there who feel just like I did. I think it is easy to project your own insecurities onto other people, assuming they won't like you, based on your criteria, not theirs. At some point you may need to work on any issues of self-worth you may have, so you stop believing that either nobody will be good enough for you, or you for them.

I know many of you wouldn't speak to me in real life because I used to be an IV drug user. Meanwhile, you seem like raging alcoholics and sex addicts to me, someone who doesn't drink and mostly did the party drugs *alone*. Party of one. Sex is a way to earn a place to sleep, not something to be enjoyed, silly people.

I'll try not to judge you if you promise the same, haha.

Nobody here has judged you in any way. The only judgement here is yours, assuming we can't possibly like you, because you don't like yourself. They are two totally separate issues and I would appreciate it, if you stop slamming the forum for doing something we never did.

Nobody here has judged you in any way. The only judgement here is yours, assuming we can't possibly like you, because you don't like yourself. They are two totally separate issues and I would appreciate it, if you stop slamming the forum for doing something we never did.

Joe

Whoah, whoah, whoah.

Read beyond the soundbite, buddy. I wrote a lengthy explanation of just that. Normally I'd say something equivocal about "let's all look at what we've written" and "maybe I mis-spoke" and "let's all calm down", but in this case *you* need to calm down a bit and not jump on people for "slamming the forum" without knowing what you're talking about.

You're also the one, now that I think about it, who said that I see evil in all people, when I see no such thing. I think you might need to follow the advice you gave to coreFighter and have a look at your own self a little bit. I'm sure you're a good person, but you seem to mis-read a lot of what I write, and the mis-reading always goes to a much darker place than I intended.

I was an IV drug user but I have never really dwelled on what people think of me for admitting it . I have been told by more than a few people that they admire the fact I was able to stop and make some sense out of my life .

I was also an IV drug user. Of course, that was 41 years ago. Used to shoot crystal meth, morphine, and heroin. You name it, I would try it,... acid, grass hash, uppers/downers... All I can say is,I am glad those years are long behind me.

I was also an IV drug user. Of course, that was 41 years ago. Used to shoot crystal meth, morphine, and heroin. You name it, I would try it,... acid, grass hash, uppers/downers... All I can say is,I am glad those years are long behind me.

I'm glad all you people "came out", as it were. I don't actually know anyone else who used to use and doesn't now, and I didn't realize this about any of you. I felt much more alone in this regard before today.

The drug use didn't actually set up the situation that you've heard me talk about a lot on here: fate took care of that on its own, and all of the other stuff that's going on kept me from using anyway. But I have a feeling if this hadn't happened now, continued drug use ("drug use" here is defined as me in a room alone with a needle in my arm) would've eventually gotten me. Maybe it's good that my company shut down, because even though that set up a chain reaction of horrible things, it also is why I quit...

I think a lot of you forget that many more people read here than post here or have accounts here. There's just a smaller group of "you" ("us", I'm a loud mouth) who actually write more than once per week.

I had an account on Poz Personals long before I signed up here, and I've been reading these forums for years.

Me and HIV go back a long way.

Edit: My point is, I only signed up when I needed help, but I've been a peeping tom for a long time, watching you silently from behind the bushes. mawahahaha, and now that I'm a member, I can say you all really need to clean your kitchens...

ps: I only shot up one time (liquid cocaine... very Eighties!) so I still reserve the right to sit in judgement as regards the rest of you

No worries. I get lumped in with them a lot. I see a distinction. THey want HIV for reasons I can't understand. I didn't care one way or the other. But every single interesting person I met for a year turned out to be positive. One friend that year called me a "poz magnet" because every single person who expressed an interest turned out to be positive. This wasn't me seeking it out. It kept coming to me.

I suffer from symbolic thinking in general, but this symbol started smacking me in the face in 2009, so I just went with it. You're right, the account on Poz Personal (which I opened about a year ago when my personality disorder became too much for my ex) was a bit much. I never met anyone from it, but actually this thread has reminded me of it, and maybe now it would be more useful...

I'm gonna go retrieve my password now. Fun!

Edit:

I tried. Boo. I wanted to see what I had written.

"This membership is on hold or has been canceled. If you feel this is an error, please contact us at personals@poz.com.Please include your user name."

I probably cancelled it in September. I didn't think I'd ever date again, and I cancelled OKCupid and Grindr and Scruff and all that stuff. I put Scruff back a few times, but I don't think I have any of the others. The other places I had (and still have, I suppose!) accounts are not mentionable in mixed company.

Ex-injecting drug user here too. I had a love affair with heroin in my early 20s (25-30 years ago).

While I've never felt judged here because of it (and many here know - I ended up with hep C due to my drug use and I talk about it now and then), I HAVE felt judged by some health care professionals who only see a junkie once they know, regardless of how long it's been since the last time I shot up.

Thankfully, that's not been my experience with all health care professionals and it's not my experience with any of my current HCPs. I tend to fire the judgemental ones toot-sweet.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

When doing risk assessment or guiding people towards safer sex I feel its not a double standard to include condoms into the advice . If you put aside monogamous couples , condoms are the gold standard in protection .

You simply cannot trust a persons claim that a UD viral load is a constant or a fact . I see that the UD aspect is mentioned quite often when discussing risk and safer sex on this board when its appropriate , monogamy or other wise .

You simply cannot trust a persons claim that a UD viral load is a constant or a fact

IMO, if you see a copy of the other person's labs, or, say, a few years worth of labs, all showing undetectable VL, you can trust that a hell of a lot more than if that other person is claiming they are HIV negative at the time of having sex, since no test can ever prove that.

IMO, if you see a copy of the other person's labs, or, say, a few years worth of labs, all showing undetectable VL, you can trust that a hell of a lot more than if that other person is claiming they are HIV negative at the time of having sex, since no test can ever prove that.

IMO, if you see a copy of the other person's labs, or, say, a few years worth of labs, all showing undetectable VL, you can trust that a hell of a lot more than if that other person is claiming they are HIV negative at the time of having sex, since no test can ever prove that.

I thought this was an urban legend, that people might actually ask to see documents, or that people might offer to show them. I know this must exist but it seems so deluded and twisted, in the context of "hook-ups" with unknown gentlemen. Not to mention vaguely OCD, and demodť. I used to see that sort of thing on places like Manhunt, circa 2000. "HIV negative and have the document to prove it."

So there are HIV+ barebackers on the merrygoround who proclaim "Undetectable and have the labs to prove it." ?

Too funny.

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ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Anyone with a computer and a printer can easily fake "papers." It was widely done when the impetus was on a negative status, and I submit that it can be just as easily done with an UD VL, especially if the trick in question is a short term/one time thing.

Honestly, the only time a, UD/VL should be a reason to bareback is if the couple is in a committed relationship. I gave my BF my bank passwords and took him to my doctor before we made any sort of decision like that.

Papers are flimsy things, but HIV remains forever as of today.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

That may be true.But my mother is more healthy than I am.She has perfect lipid and cholesterol profiles, unlike me.And she is 60 y.o, while I'm 31.

My mom is very likely to live a happy life into late 80ies, just likemy grandparents did.

I will be lucky to reach 65 years of age.30 years more of hiding, poor sleep and terrible lipid profile in my blooddue to ''happy pills'' (1Kivexa/Epzicom+1Sustiva)...I'm not sureyoga and meditation will be able to help anymore...

That may be true.But my mother is more healthy than I am.She has perfect lipid and cholesterol profiles, unlike me.And she is 60 y.o, while I'm 31.

My mom is very likely to live a happy life into late 80ies, just likemy grandparents did.

I will be lucky to reach 65 years of age.30 years more of hiding, poor sleep and terrible lipid profile in my blooddue to ''happy pills'' (1Kivexa/Epzicom+1Sustiva)...I'm not sureyoga and meditation will be able to help anymore...

Im not sure, but I seem to recall you are celibate since your diagnosis..

You know, if you are 30 and "only" expect 35 more years, is it possible to start living a bit more loosey goosey, somehow? I mean, you're a young man, live it up a little... Not possible?

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ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

I get the impression there's a growing, critical mass of HIV+ guys casually barebacking, more every year.

Show me the data. Impressions don't count. It may be true but I want data before I form a view. Equally it may be false, as may be the case the UK (we have conflicting models, but no real data). It may be that a high rate of condom use by men who have sex with men has averted many 100s of 1000s of cases of HIV (as suggest by recent models, ta to us) and condom use continues at a reasonably if not ideal level (as suggest by recent models, ta to us). Sault people shagging around, but try and do better (if this is possible).

The short of it is ARVs change the HIV prevention game, and tough shit people who aren't happy with this. It's a fact, albeit a complex one. Complexity is not helpful if you are dressed as a giant condom in a mall promoting "safe sex" (or alternative costumes/venues) but that is what we got. We got progress.

The critical mass you refer to is called the "undiagnosed fraction" ie those enthusiastic shaggers who think the are HIV-negative but don't go get tested. How to convince these people to get tested, and test often, is an important question to answer.

That may be true.But my mother is more healthy than I am.She has perfect lipid and cholesterol profiles, unlike me.And she is 60 y.o, while I'm 31.

My mom is very likely to live a happy life into late 80ies, just likemy grandparents did.

I will be lucky to reach 65 years of age.30 years more of hiding, poor sleep and terrible lipid profile in my blooddue to ''happy pills'' (1Kivexa/Epzicom+1Sustiva)...I'm not sureyoga and meditation will be able to help anymore...

You realize that your pill regimen is not set in stone. It really looks like Sustiva in particular has been doing a real number on you for a long time.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

How to convince these people to get tested, and test often, is an important question to answer.- matt

There's the rub. In a society that rewards ignorance with acceptance, it will take a long while before the stigma and the UB2 mentality wanes, and people get tested.

In the meantime, we can only trumpet the science, and hope there is a resonance.

And, of course, be "out" ourselves.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

So there are HIV+ barebackers on the merrygoround who proclaim "Undetectable and have the labs to prove it." ?

Too funny.

I'm not quite sure how you get that. All I am saying is that you can prove undetectable viral load from labs, but you cannot prove HIV- status from labs due to the testing window.

Even if someone ended up going off treatment since their last viral load test, it sometimes can take a while for the viral load to rebound. I would trust a recent UD viral load test result more than a recent HIV- antibody test result. But I would never personally ask for any labs anyway.

As for the one person who did ask for my labs, I do know he spent time reading the links I texted him one evening on the studies about undetectable VL . He was turned off enough not to proceed. But the next day he did text back, we met, and he asked to see labs my at that time, which I had previously offered to show. He asked for bb then. He never admitted to being poz. Could he have been poz ? Of course. I do not know that for a fact. There is simply no way for me to be sure of it.

Obviously different disclosure approaches can apply to different places.It is never easy no matter what. But sadly, in bathhouses, most of the time, the safe sex discussions just don't even happen. When I go there, I usually am the one asking first if the other plays safe, and then disclosing my status. As you can imagine, I don't score very often in the bathhouses. If these discussions happened consistently (and honestly), I think the bathhouses would have been out of business a long time ago. Bathhouses in the US tend to be only about twice a year visits for me now.

The bathhouses in Bangkok and Vietnam were very hot though, and it's really hard to disclose when you don't speak the other person's language. Not that this doesn't happen in US bathhouses either, just less.

Definitely, but we live in a modern age, who said these documents had to be on paper ?

Logging in on a secure medical provider site to view a copy of the labs is a little bit harder to fake.

And yes, this can be done even in a bathhouse, on a smartphone, if you and the other person are so inclined.

Kaiser still doesn't list the viral load on the labs online, though. Must that pesky "HIV" word. I wish they did. I hope they will, someday. But they now do list CD4 and CD4% , which they did not use to. The VL test is the only one I can't see online in the "test results" page now.

Kaiser has stopped mailing me any paper copies of the labs in the last 6 months. The only evidence that I have of my most recent UD VL is some secure email from my doctor on the Kaiser site of him responding to my question about the last VL test and confirming that it was UD.

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It was widely done when the impetus was on a negative status, and I submit that it can be just as easily done with an UD VL, especially if the trick in question is a short term/one time thing.

Yes, however, to first admit that you are HIV positive, and then fake your viral load test, would be really wicked. Most people will stop talking at the first admission, anyway, and will not understand or want to learn what UD means.

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Honestly, the only time a, UD/VL should be a reason to bareback is if the couple is in a committed relationship.

Ideally yes, but this is not happens all of the time.

Anyway, I was not advocating using the UD/VL test result as a reason to necessarily bareback. Other than HIV transmission, we know bareback leads to STDs which are never pleasant or desirable.

However, the UD/VL test is, IMO, a factor that should be considered prior to having sex, even with a trick, just like the use of condoms should be considered. They are both risk reduction factors for HIV transmission. Unfortunately, only one of those two is widely known.

What I am saying is that it may be that the risk for HIV transmission to you is greater if you use a condom with a trick of "HIV-" or unknown HIV status, than if you use a condom with a trick of known HIV+ status with undetectable viral load.

Reasons for that being - in the first case, if the condom break, the trick may actually be HIV+ and highly infectious. Even if you are aware of it and request it, you may be denied PEP unless your trick was previously confirmed HIV+ .

In the second case, if the condom breaks, the risk is lowered by the UD VL, plus you are going to get PEP if you request it.

Obviously the risk goes up quite a bit if you bareback, but much more so for the first situation.

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I gave my BF my bank passwords and took him to my doctor before we made any sort of decision like that.

I probably should have done the same, it didn't happen in that other order for me and my bf. He might still be neg. But we had both tested neg originally when we decided to bb. That was a long time ago.

There's the rub. In a society that rewards ignorance with acceptance, it will take a long while before the stigma and the UB2 mentality wanes, and people get tested.

I am really not sure what the elapsing of time is going to do for the stigma. Especially in the US where HIV is most prevalent among gay men. It appears the HIV stigma is actually less in countries with much higher rates of HIV accross the entire population.

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In the meantime, we can only trumpet the science, and hope there is a resonance.

And, of course, be "out" ourselves.

Yes, being "out" ourselves is a huge part of it.

I am afraid I really don't see many people being "out" about their status.

We are a minority within a minority, and that is a tough place to create awareness and eliminate stigma.

Well, I think the stigma will eventually decrease when treatment as prevention meets once weekly, once monthly, or bi-annually treatment meets affordability.

This, combined with the natural inclination of HIV to slowly evolve into a less dangerous pathogen and the rather rapid explosion of gay acceptance will all create a different atmosphere than what we have today. Talking decade away probably for the first two, maybe more. Looking at fifty or so years for the latter, barring a working cure (or an actual cure) in the meantime.

The advances that have happened with HIV/AIDS treatments have been nearly unprecedented in human history. Perhaps the discovery of penicillin comes close. We are so different than we even were a decade ago in terms of acceptance and "mainstreaming." We have a shit-ton more to do, but I am amazed at how far we've come, both in distance and velocity.

As for being out, we really are everywhere. And I strongly suspect the Millennial Generation will have far less tolerance for ostracizations than the generations before. Or at least, it's important for me to think that.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Well, I think the stigma will eventually decrease when treatment as prevention meets once weekly, once monthly, or bi-annually treatment meets affordability.

But those infrequent treatments as prevention aren't there now, and won't likely be affordable for 17 years after they become available. Unless somehow the patent system is changed. So this route still means decades.

But I don't quite see how the less frequent treatments will reduce stigma. It's a benefit to us, the patients, sure. But I don't quite see what it changes in the perception.

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This, combined with the natural inclination of HIV to slowly evolve into a less dangerous pathogen

Do you have evidence that this is currently happening ?

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and the rather rapid explosion of gay acceptance will all create a different atmosphere than what we have today.

Gay acceptance is a factor yes, but unfortunately, I am not seeing it go hand-in-hand with poz acceptance.

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The advances that have happened with HIV/AIDS treatments have been nearly unprecedented in human history. Perhaps the discovery of penicillin comes close. We are so different than we even were a decade ago in terms of acceptance and "mainstreaming."

You are probably right the progress is huge medically. I was too young during that painful early history of HIV/AIDS to know what it must really have been like.

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We have a shit-ton more to do, but I am amazed at how far we've come, both in distance and velocity.

As for being out, we really are everywhere. And I strongly suspect the Millennial Generation will have far less tolerance for ostracizations than the generations before. Or at least, it's important for me to think that.

Well, that depends how you define the acceptance and tolerance and on the context.

I certainly haven't had any friends, family members, or coworkers shun me for disclosing.

In the context of casual sex, however, the ostracism is alive and well.

Most of the time, the reaction I get is a polite "thank you for being honest, but no thanks", which is a sort of cognitive dissonance, IMO.

But today I got the most hurtful reaction I have ever received. I don't know why it's still in my phone. I probably could write a book on all the nasty reactions I have had, but it would be way too depressing to keep track of and write. So, I am really not as optimistic at all.

I don't think we can change the attitudes from within, one poz guy at a time, telling neg guys about viral load, who have never heard of it, don't know what it means, and most of the time don't want to know. IMO, this is a failure of sex education. Maybe it is too early, or the message is too complicated, but I truly feel these things need to be taught, just like condoms.

But those infrequent treatments as prevention aren't there now, and won't likely be affordable for 17 years after they become available. Unless somehow the patent system is changed. So this route still means decades.

But I don't quite see how the less frequent treatments will reduce stigma. It's a benefit to us, the patients, sure. But I don't quite see what it changes in the perception.

First, these infrequent treatments are either already in or heading into stage III trials as I type (I am on a waiting list for one of them actually, though I am reconsidering given my circumstances) and I have confidence that affordable HIV treatments will be global in less than half the time you present. I do not doubt the struggle to make this happen, but I think the paradigm shift over the last twenty years has brought us pretty far, and the current political climate is helping the process.

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Do you have evidence that this is currently happening ?

More supposition based on the rapid evolution of HIV, combined with the historical decrease in mortality in other pathogens through recorded history. I have a couple of quick links, and will try to scrounge up more later if I can. These are NOT all first tier stuff, but they are not without precedence.

It is interesting in the last article and some others that the introduction of antiviral drugs and the subsequent emergence of resistant strains might work to slow the evolution into a more symbiotic virus, delaying or even reversing the process. I tend to favor evolution myself, but freely admit that only time will tell.

I posit that infrequent treatment (with accompanying infrequent side effects) combined with widespread access would A) destigmatize the HIV experience as a whole, B) sharply reduce new transmissions, and C) act as a catalyst for social change within the affected communities to decrease the stigma associated with infection outside those communities.

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Gay acceptance is a factor yes, but unfortunately, I am not seeing it go hand-in-hand with poz acceptance.

Oh, I don't think it is going hand in hand. Poz acceptance within the gay male community is leagues behind what gay acceptance is within the general population. But I see real signs of improvement, very recently in fact. Grassroots organizations like Team Friendly:

have popped up in multiple states, for example, to address exactly that issue. These organizations simply would not have existed twenty, ten, or perhaps even five years ago. I suspect that these types of organizations will be the next wave of HIV education. Only, of course, if people younger than myself get involved.

The things you mentioned having happened to you? They happened to me as well. Without regaling you with horror stories, suffice it to say that the early and mid 90s were illuminating for me, as I experienced the absolute best - and the absolute worst - in humanity. Both from a cultural and personal perspective. Disclosing in public over dinner and having my companion - a nurse - break out in tears and literally run out, leaving me with the check sort of stuff.

When I was running my little outreach organization from 94-2000, one of the common problems was that HIV negative people were afraid to participate because the bar crowd would assume they were positive and shun them. That fear was all too often justified. I see that changing, and I believe that the things I outlined above, along with other factors (time elapsed since the pandemic was a horror show for example) will continue this trajectory.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

This thread seems to be wandering all over the place, however I'd like to return to Ann's post way up the thread where she explains some of the differences between a vagina and a rectum. Today I read of yet an additional physiological difference, the identification and localization of a newly described Interferon and one that is found exclusively within the epithelial cells of the female reproductive tract.

Type I interferons (IFNs) are critical cytokines involved in host defense against pathogens, particularly viruses. IFN-ɛ is an IFN-like gene encoded within the type I IFN locus in mice and humans whose function has not been characterized. Fung et al. (p. 1088) created mice with a genetic deletion in Ifn-ɛ and found that, like other type I IFNs, IFN-ɛ signals through the IFN-α receptors 1 and 2. However, unlike these other cytokines, which are primarily expressed by immune cells and are induced upon immune cell triggering, IFN-ɛ was expressed exclusively by epithelial cells of the female reproductive tract in both mice and humans and its expression was hormonally regulated. IFN-ɛĖdeficient mice were more susceptible to infection with herpes simplex virus 2 and Chlamydia muridarum, two common sexually transmitted pathogens.

This thread seems to be wandering all over the place, however I'd like to return to Ann's post way up the thread where she explains some of the differences between a vagina and a rectum. Today I read of yet an additional physiological difference, the identification and localization of a newly described Interferon and one that is found exclusively within the epithelial cells of the female reproductive tract.

Type I interferons (IFNs) are critical cytokines involved in host defense against pathogens, particularly viruses. IFN-ɛ is an IFN-like gene encoded within the type I IFN locus in mice and humans whose function has not been characterized. Fung et al. (p. 1088) created mice with a genetic deletion in Ifn-ɛ and found that, like other type I IFNs, IFN-ɛ signals through the IFN-α receptors 1 and 2. However, unlike these other cytokines, which are primarily expressed by immune cells and are induced upon immune cell triggering, IFN-ɛ was expressed exclusively by epithelial cells of the female reproductive tract in both mice and humans and its expression was hormonally regulated. IFN-ɛdeficient mice were more susceptible to infection with herpes simplex virus 2 and Chlamydia muridarum, two common sexually transmitted pathogens.

With all due respect and without having to take the time and regester to view the source you copy and paste from ... discussing cytokines and mice rectums is rather tedious for some of us and not well understood but thanks for bringing us back on topic though . I swear I heard my spell check yawn just a moment ago .

i am also of the opinion that, in the LIVING WITH section, dealing with the entirety of the "double standard" and why it persists involves not only discussions of the differences of anal v vaginal tissue, but also the changing paradigm of prevention and treatment - which will undoubtedly alter the perception of barebacking.

I see the changes in treatment, treatment as prevention, and functional cures as a direct reply to the OP. If someone wishes to keep the discussion purely within the realm of the physical differences between anuses and vaginas, then perhaps the Research and Treatment forum is a better fit for that discussion.

As I see it, no paradigm can exist in a vacuum. And no paradigm can be changed with the stroke of a single brush (or as I see it, a single hair from what is essentially the same brush.)

The physiology and psychology of HIV are intertwined to the point where isolating one hair on the aforementioned brush, while intellectually stimulating, is no sufficient to provide anything resembling a plan to move forward.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."